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Most medical plans do not include coverage for dental services. Often, routine dental services are covered through a separate plan.
Like medical plans, most dental plans have certain defined out-of-pocket costs for members, like co-insurance, co-payments, and deductibles. These cost- sharing elements help control costs and keep plan premiums at affordable levels. However, dental plans differ in that they typically reimburse plan participants based on the “class of service.” For example, preventive and diagnostic services are often covered at 100% of the cost of the procedure, basic restorative services (such as fillings) may be covered at 80% and plan participants must pay more for major services such as crowns, which are covered at a lower rate, such as 50%.